Private hospitals need to support GP uploads for PCEHR funds

Written by Kate McDonald on 24 November 2014.

Private hospitals looking to apply for funding from the National E-Health Transition Authority (NEHTA) to assist them in connecting to the PCEHR will be required to outline proposed activities to support eHealth activity by local healthcare providers such as GPs, as well as supporting their own clinicians.

NEHTA has released the details of its Private Hospital PCEHR Rapid Implementation Program (RIP), which will see a $500,000 funding pool on offer to help with some of the technical requirements of connecting to the HI Service and PCEHR, and to allow for uploading and viewing of clinical documents.

NEHTA said the funds are intended to assist private hospital organisations accelerate their eHealth readiness, and are not intended to cover the entirety of eHealth implementation costs.

As part of the statement of requirements for funding, private hospital operators will need to provide an outline of proposed activities by the organisation to encourage clinicians to embed PCEHR viewing in clinical workflows.

Operators will also need to outline proposed activities to support eHealth use by local healthcare providers, such as encouraging the preparation and uploading of shared health summaries by local GPs prior to patients being admitted to hospital.

Applications must be accompanied by letters of support from at least two senior clinicians employed with or credentialed by the facility, indicating their willingness to help with meaningful use of the PCEHR as part of routine clinical workflows.

Operators will also need to show how they intend to encourage registration for the PCEHR by patients, such as providing information on it in pre-admission materials.

NEHTA said it expects the majority of funding offers to be between $50,000 and $100,000. Agreements will be signed with successful organisations in January or February 2015, with all elements of the deployment to be completed by June 30, 2015.

In return, NEHTA will make available free of charge some support packages, including architectural guidance and advice, technical installation and configuration support, and change and adoption support.

It will also provide what it is calling eHealth Integration Sample Code (eHISC), which has been developed as part of the Healthcare Identifier and PCEHR Services (HIPS) middleware that is being used by public hospitals in Queensland, South Australia, Western Australia, Tasmania and the Northern Territory.

“When deployed by an implementer as part of their software solution, the eHISC operates as middleware to connect existing hospital systems to the HI service and the PCEHR service,” NEHTA said.

“In current public hospital deployments, it enables a local clinical information system to gain access to the eHealth record system, retrieve and upload clinical documents, and interact with the Healthcare Identifiers (HI) Service.”

It can also retrieve HI Service information such as the patient's IHI, retrieve the patient's PCEHR information, upload documents in CDA format to the PCEHR, help with assisted registration and also provides an integrated view to allow clinicians to view a patient's PCEHR.

According to NEHTA, the capability of HIPS is currently being expanded to include the ability to put a wrapper around a PDF document so it can be uploaded. This is necessary following the decision to upload pathology and diagnostic imaging reports as immutable PDFs in advance of the technical capability to upload results as atomic data.

HIPS is also being integrated with the National Health Services Directory to support point-to-point communications, NEHTA said.

Prerequisites for hospitals include already using a clinical information system or patient administration system that can be modified to launch a web browser to view the patient's PCEHR and to configure HL7 admission/discharge/transfer (ADT) messages to other systems.

“Viewing the PCEHR will allow hospital clinicians to directly view a consenting patient’s important health information where available from primary and community care settings – in particular, the patient’s shared health summary, prescriptions and community pharmacy dispense records, public hospital discharge summaries and additional clinical documents as they are added to the PCEHR in the future (e.g. pathology and diagnostic imaging reports),” NEHTA said.

“Knowing that such documents are being viewed within acute settings will further encourage the creation of these documents within the primary and community care settings.

“Additionally, private hospital organisations uploading relevant clinical documents – such as discharge summaries or medication records for example - to the PCEHR system will encourage further meaningful use of the system.”

One sector that is not particularly happy with the development is aged care, with representatives saying this vital sector is missing out.

Patrick Reid, CEO of Leading Age Services Australia (LASA), which represents for-profit aged care providers, said that while the money on offer to private hospitals was welcome, it was essential that aged service providers were also included.

Mr Reid said aged services need to be recognised, considering they come second only to the state health system in volume.

“To date industry integration has not been supported and yet it is crucial to better care and reducing unnecessary costs,” Mr Reid said.

“The PCEHR can have a very positive impact on the needs of the increasing ageing population. It is a revolution for consumers and health care providers, but still age services are being left behind.

“On behalf of the age services industry I call on Health Minister Peter Dutton to take steps to urgently fund aged care providers to integrate their systems with the PCEHR.”

NEHTA is holding a webinar for prospective applicants for private hospital funding on Tuesday, December 2.